An increasingly popular pregnancy method used by celebrities including Jimmy Fallon and Kim Kardashian is associated with an increased risk of complications and death.

A new study found surrogates, women who carry and deliver a pregnancy for someone else, are more likely to experience life-threatening complications and death during pregnancy than women who give 𝐛𝐢𝐫𝐭𝐡 to their own 𝘤𝘩𝘪𝘭𝘥ren.

By looking at data from more than 800,000 pregnancies in Canada, researchers determined surrogates were likely to develop preeclampsia, a potentially fatal condition that causes high blood pressure, nausea and vomiting.

It’s also been linked to an increased risk of heart disease and stroke later in life.

The rate of life threatening health issues that can occur during or after 𝘤𝘩𝘪𝘭𝘥𝐛𝐢𝐫𝐭𝐡 was eight percent in the surrogates, compared with two percent of people who carried their own babies.

People choose to use a surrogate for a number of reasons – be it complicated previous pregnancies or infertility. Jimmy Fallon has spoken about he and his wife’s decision to use a surrogate. Kim Kardashian has also shared her experience with surrogacy, using two different women to have 𝘤𝘩𝘪𝘭𝘥ren with Kanye West

Study Author Dr Maria Velez, an obstetrician at Queen’s University in Canada, said these risks need to be considered by people interested in paying other people to carry their babies.

Dr Velez said: ‘Clinicians involved in the care of individuals and couples who need a gestational carrier to build their family should counsel their patients and the gestational carriers about the potential risk during pregnancy and early postpartum.’

Surrogacy, when the embryos from one couple are implanted into the womb of another woman who carries the 𝑏𝑎𝑏𝑦 to term, has become more popular with increasing medical advances.

The researchers analyzed 863,017 pregnancies from 2012 to 2021, 806 of which were surrogacies, and published their findings in the journal Annals of Internal Medicine.

Though the topic remains controversial, the authors note, few studies had actually been performed to see what the safety of surrogate pregnancies were compared to normal 𝘤𝘩𝘪𝘭𝘥𝐛𝐢𝐫𝐭𝐡.

Dr Velez said: ‘The study was prompted by an increased in the use of gestational carriers worldwide and a lack of information about the impact of this reproductive modality on pregnancy outcomes, for the gestational carrier and the offspring.’

Child𝐛𝐢𝐫𝐭𝐡 is inherently risky. When giving 𝐛𝐢𝐫𝐭𝐡, new mothers risk massive blood loss, tissue tears and changes to blood pressure.

One well-known complication is a condition is preeclampsia – a sudden and dangerous change in a mother’s blood pressure during pregnancy or 𝘤𝘩𝘪𝘭𝘥 𝐛𝐢𝐫𝐭𝐡 that can lead to premature 𝐛𝐢𝐫𝐭𝐡, liver damage, seizure, comas, cardiovascular disease and death.

It affects about five to eight percent of all pregnancies in the US, and is more common in women who are obese, over age 35 or have autoimmune disorders.

The study found that eight percent of surrogate 𝐛𝐢𝐫𝐭𝐡s had some sort of life-threatening complications, particularly preeclampsia and massive bleeding.

This was four times the rate of the natural 𝐛𝐢𝐫𝐭𝐡 group – where two percent of pregnancies resulted in complications at 𝐛𝐢𝐫𝐭𝐡.

Also, surrogates were more likely to give 𝐛𝐢𝐫𝐭𝐡 prematurely – before 37 weeks gestation – than other women. Still, on the whole, the babies 𝐛𝐨𝐫𝐧 to them were as healthy as the babies 𝐛𝐨𝐫𝐧 to their biological mothers.

The authors note that screening guidelines for surrogates should weed out existing health conditions that would make them more likely to have a complicated pregnancy. But, Dr Velez said: ‘these guidelines are not always strictly followed.’

On the whole, surrogacy is still a relatively rare situation.

This is likely because it costs a lot of money to support a surrogate  – it can cost more than $200,000 according to American Surrogacy – making it the stuff of the wealthy.

Researchers found risks were outsized in women who opted to be surrogates than in women who gave 𝐛𝐢𝐫𝐭𝐡 to their own biological 𝘤𝘩𝘪𝘭𝘥ren

The paycheck is a reason some surrogates opt into this contract. Others say they agree to be a surrogate just to help couples who can’t conceive on their own.

The people who seek out a surrogate likewise have a number of motivations. Some had previous risky pregnancies. Others are infertile, or are in a same-𝓈ℯ𝓍 partnership where it’s not possible to carry a 𝑏𝑎𝑏𝑦 yourself.

One of the factors that complicates surrogacy in the US is that it’s not legal in every state. Nebraska and Louisiana currently prohibit paid surrogacy.

Paid surrogacy was brought to the spotlight in the 1980’s by a controversial legal case wherein a surrogate who was paid to carry the pregnancy of a couple in New Jersey had a change of heart after giving 𝐛𝐢𝐫𝐭𝐡, and decided she wanted to keep the 𝑏𝑎𝑏𝑦.

The couple who paid the woman to carry the 𝘤𝘩𝘪𝘭𝘥 sued, and were eventually granted custody. In response, New Jersey, New York and other states instated a ban on paid surrogacy that lasted years.

The case, known popularly as ‘𝑏𝑎𝑏𝑦 M’  – made surrogacy a national controversial topic, with people questioning the ethics of wealthy couples paying surrogates, who are sometimes substantially poorer – for the temporary use of their womb.

In Canada, where the study was performed, surrogacy is largely legal, with some restrictions.